Intimacy & Sex

Intimacy and sex go beyond the physical to incorporate fundamental aspects of who we are, how we feel about ourselves and our bodies, and how we relate to others. Many young people find some or all of these things affected by their cancer experience, regardless of whether or not they are in a relationship or sexually active.

This topic explores the many dimensions of intimacy and sex, some of the common cancer-related concerns young people have, and strategies for managing these.


Intimacy and sex can be big topics to discuss, so let’s be clear with what we’re talking about and why. Sex involves the physical act of intercourse but also other forms of intimacy. Intimacy, on the other hand, is much more than just sex. It relates to how we interact with people we care about on every level- physically, emotionally, mentally, intellectually and spiritually.

Our confidence, body image, self-identity and sexuality are also important factors- all of which can be impacted by cancer and its treatment. Click the boxes below to unpack these and some related concepts a bit further.

The way we see ourselves is really important to our sense of self-worth, our confidence and how we interact with others. Having self-confidence means we feel good about and believe in ourselves, and feel liked and accepted. Our sense of self and self-confidence comes from what we say about ourselves out loud and in our heads, what others tell us and our sense of achievement.

Having self-confidence and a positive sense of self is something we all have to continue working on throughout our lives, because sometimes we feel good about ourselves and sometimes we don’t! Working on these things helps us to live our best lives and engage in positive relationships with others. This contributes a lot to our emotional health and wellbeing.

Body image refers to how you see, think and feel about your body. Healthy body image means feeling relaxed and good about- and in- your body. Unhealthy body image is feeling negative about, being fixated on, or constantly trying to change your body.

Unhealthy body image can really impact on the way we live our lives and interact with others- see the ‘Emotional Health & Wellbeing’ topic for more.

Gender identity relates to our sense of being a woman or a man, both or neither. This can be the same or different from our actual physical bodies. Sexuality and sexual identity are the unique ways we describe who we are attracted to physically, romantically and/or sexually.

If we are attracted to people of a different sex or gender, we may identify as heterosexual or straight. If we are attracted to people of the same sex or gender, we may identify as gay or lesbian. If we are attracted to both we may identify as bisexual. Or we may prefer to identify as queer, gender fluid, trans, non-binary or in another way.

These concepts are very broad and often evolve in terms of language used and how we identify at a particular time, so know that it’s normal if you’re still working this out or find that how you identify changes over time.

Sexuality is about self-image and body image. It is also about how we express ourselves sexually and our sexual feelings for others. This can be expressed in many different ways including the way we present in the world, the clothes we wear, the way we have sex, if we want to have sex, who we have sex with and how often. Often comfort with our sexuality grows over time as our self-confidence grows and we get to know ourselves better.

Sex encompasses a lot of acts and can mean different things to different people. When people talk about ‘having sex’ they are often referring to sexual intercourse or penetrative sex, but sex includes all forms of sexual activity including oral sex and non-penetrative sex. We can also be sexual without having sex e.g. by kissing, through masturbation or self-pleasure or mutual masturbation.

Deciding if or when to have sex for the first time can be a major source of stress. Remember that you are in charge of your choices about sex, sexual activities and your body. It is also important to know how to practice safe sex to protect your sexual health and prevent unwanted pregnancy.

Sexual health is about all aspects of sexual wellbeing, including access to inclusive, safe and appropriate health services and information, having healthy and respectful relationships, and having sex in a way that is safe and healthy. This includes having consensual sex that is pleasurable and safe. It also involves protecting our bodies from sexually transmitted infections (STIs)

STIs can cause a range of symptoms and can have long term health and fertility impacts. Common STIs include chlamydia, gonorrhoea, syphilis, hepatitis B, herpes and HPV. It is important to practice safe sex to protect your sexual health., and unwanted pregnancy with the use of appropriate contraception.

Sex is one way to express intimacy but intimacy is about so much more than sex. It is about being close to someone else physically and emotionally.

Intimacy is about loving and being loved, demonstrating mutual care and concern, demonstrating value for another person and feeling valued. There are many ways you can show intimacy, including communicating effectively, talking and listening, sharing physical space or meaningful experiences, through physical touch and being affectionate.

Intimate relationships with a partner are often both rewarding and challenging- especially our first intimate relationship. There are several key indicators of ‘healthy’ and ‘unhealthy’ relationships. Healthy relationships are those that are positive and respectful. They involve:

  • respect, honesty and trust
  • love, companionship and shared interests and activities
  • mutual emotional support
  • intimacy
  • good communication
  • agreement about important matters relating to how we live our lives
  • shared hopes and dreams for the future

Unhealthy relationships involve the opposite of these things and can be one sided, controlling, involve lots of conflict, cause us to doubt or question ourselves or make us feel unsafe.


Cancer-related changes to how your body looks, works and feels can affect your intimate relationships in ways you may or may not expect. The same goes for changes to how you see or relate to yourself, others and the world around you.

Some common impacts to intimacy and sex experienced by young people include:

  • Changed relationships or the loss of a relationship
  • Difficulties with communication, especially at times of stress
  • Worry about meeting new partners and whether/how to talk about cancer
  • Reduced interest in or desire for sex
  • Difficulty engaging in sex and/or reaching orgasm
  • Painful sex or loss/change of sensation

While some sexual effects such as vaginal dryness, erection difficulties, or changes to sensation or sex drive can be related to treatment, these and other impacts to sex and intimacy can also be caused by the emotional or physical changes a cancer experience often brings about. Difficult emotions or changes in body image can make it hard to connect with others in an intimate way (sexually or emotionally), as can pain, fatigue or other physical effects. Impacts to intimacy and sex can also affect our emotional health and wellbeing.

While it’s common for intimacy and sex to be affected by a cancer experience, the good news is that there are things you can to do help (and that with time, practice and a bit of patience, things usually get back on track).


How we see, think and feel about our bodies is critical to our experience of intimacy and sex, and is something that changes for many young people after a cancer experience.

Check out this topic’s video for a unique perspective on body image that you may find helpful, or the topic on ‘Emotional Health & Wellbeing’ for more information.


Intimacy and sex are normal, healthy parts of adult life. Some useful strategies for dealing with common post-treatment challenges are below, but it’s important to know that you can always talk to your general practitioner (GP) or treating team about any concerns you have.

Supporting young people with questions about intimacy and sex is part of their job, so while discussing these topics can feel challenging or embarrassing, remember that they’ve heard it all before and will be able to offer strategies to help.

There are often physical and emotional effects of cancer that can play a part in sex and intimacy worries. Check out the topics on ‘Exercise’, ‘Diet & Nutrition’, ‘Fatigue’, ‘Emotional Health & Wellbeing’ and ‘Your GP & Late Effects’ for information and tips to manage.


  • Give yourself time – It takes time to get used to changes following treatment, and our needs, desires and wants can also change over time. Give yourself time to adjust, work out what you need and what works for you, and recognise that your partner (if you have one) might need some time to understand this as well.
  • Communication is key – Talk openly with intimate partners. Let them know how you’re feeling, any fears or worries, what you want or like and when you are ready to have sex (or not). Asking how they are feeling about these things and listening to their responses, needs and wants is important too.
  • Familiarise yourself – It can help to familiarise yourself with any physical changes to your body and what makes you feel physically and emotionally good. This may mean looking at yourself in a mirror and exploring new sensations. If you have a partner, it can also help to familiarise them with any changes and needs before engaging in sex. This can allow you both to get used to differences and how these make you feel.
  • Take it slowly – It may be easier to build intimacy and sexual connection with cuddles or a sensual massage first, rather than going straight to sex.
  • Get creative – Explore with kissing, touching, oral sex, mutual masturbation, or using sex toys. You can also try different sexual positions or use props including pillows to see what works for you.
  • Plan ahead – Initially sex may need to be less spontaneous. Choosing a particular time can help deal with pain and fatigue, and can also build arousal.
  • Set the scene – A little preparation by way of lighting, music or whatever makes you feel sexy and comfortable can help.
  • Be patient – Remember that it’s ok to take time to adjust and that things often improve with time and practice.
  • Ask for help – Talk to your GP, a couples counsellor or a sex therapist to help you find solutions to challenges with sex, libido and intimacy.

There are tricks to help with vaginal dryness (problems getting “wet”), painful sex, hormonal changes and/or menopausal symptoms. These include:

  • Use plenty of water-based or silicone-based lubricant to help with vaginal dryness. These can be bought at a local supermarket or prescribed by a GP
  • Take more time before and during sex to help the vagina become more lubricated
  • Try to relax. Focus on your breathing to try and relax the vaginal muscles before and during sex
  • Use a vibrator to enhance sensation
  • Guide your partner and tell them what works for you
  • Use pillows to support parts of your body
  • Try new positions to control the depth if having penetrative sex, or experiment with all-over touching, oral sex, masturbation or sex aids instead
  • Ask your doctor about checking your hormone levels- some hormone treatments can help

There are strategies to help manage changes to erectile function (getting an erection or ‘hard on’) or impacts to sex drive. These include:

  • Take more time before and during sex to reach erection, or you can try having sex with a partially-erect penis (you do not need a full erection to have an orgasm)
  • Consider sex without penetration. Experiment with all-over touching, oral sex, masturbation or sex aids
  • Ask your doctor about medication or implants to help with erections
  • Ask your doctor about checking your hormone levels- some hormone treatments can help


While the emotional impacts of a cancer experience can affect sex, intimacy and our relationships with others, impacts to sex and intimacy can also affect our emotional health and wellbeing. Dealing with difficult thoughts and feelings is a common aspect of this for many young people.

Below are some strategies you may find helpful in managing difficult thoughts and feelings and promoting good emotional health overall, but it’s also important to know when and how to ask for help. Check out the topic on ‘Emotional Health & Wellbeing’ for a more complete picture on how to look after this side of your health after treatment and manage any challenges or concerns you may be experiencing.

  • Name what you’re feeling – Noticing, identifying and actually naming difficult or uncomfortable feelings (whether out loud to yourself or by writing them down) can reduce their intensity and help you to understand and respond. A lot of people find journaling a good way to practice this.
  • Accept your feelings – We all experience difficult thoughts and feelings in life, and while we can’t always control how we feel, we can choose how we respond. Accepting difficult feelings means making space for them. Let them be there, notice them, and consider what they might be trying to tell you, but let go of the emotional attachment you give them. Know that they can and usually do pass, and are a normal part of our human experience.
  • Learn to be mindful – Mindfulness is the practice of purposefully paying attention to the present moment. You can be mindful by paying attention to your breath, your physical surroundings, your body, or anything else that is in front of you here and now. It can help calm a racing mind, with worrying or thinking difficult thoughts. An app like Smiling Mind is a great place to start.
  • Practice self-care – Self-care is about making sure your cup is full. This can mean making sure you get enough sleep, eat well and exercise regularly, but it also means making time to do the things that are important to you and make you feel good. Being kind to yourself is key.
  • Ask for help – If you’re struggling with thoughts or feelings that are affecting your relationships or other areas of your life, talk to your healthcare team. Your GP is often best placed to assist, and can link you in with a mental health professional that can help you understand more about what you’re feeling and provide strategies specifically for you.


Cancer can bring out the best and the worst and put a strain on even the strongest of relationships. It can also impact future relationships and how comfortable you feel meeting a new partner. For those in a relationship, some common concerns include:

  • Difficulties with communication, especially at times of stress
  • Conflict or increased arguments
  • Changing needs of one or both partners
  • Big emotional changes or challenges for both partners, including feelings of fear, sadness, depression, anxiety, worry, confusion, anger, frustration or guilt

These kinds of experiences are common and can come up long after treatment has finished. Keep in mind that your partner has their own experience of what you’ve been through, and that they may be struggling in different ways.

As you both find your way forward post-treatment, remember that intimacy and sexual attraction involve connections built on physical, emotional, intellectual and spiritual levels, and that it’s important to nurture yourselves and your relationship on all of these levels. The following strategies may help.

  • Communication is key – Talking honestly and openly about feelings, needs and concerns- and respecting any differences between you- is so important to preserving and building closeness in your relationship. Do your best to keep the lines of communication open and acknowledge the shared and individual experiences of what you’ve both been through.
  • Build intimacy – Intimacy can take time to build or rebuild and often takes conscious effort. Spend time together, pursue shared interests and activities, and identify and talk about common goals to work towards. It also helps to work out what makes you and your partner feel loved, and then make it a priority to offer these things to each other.
  • Be patient – It takes time to adjust following an experience as life-altering as cancer. The importance of good communication and efforts to strengthen intimacy aside, be patient with yourself and your partner, and know that things often improve with time.
  • Ask for help – Talking to your GP or a couples counselling professional can help you find effective solutions to any relationship challenges you may be experiencing.


Your GP and treating team know that intimacy and sex (if you choose to have it) are just as important to health and wellbeing as any other aspect of your recovery, so be sure to talk to them about any concerns you have. They will be able to provide information and resources specific to you, but those listed below are a great place to start.

  • Sexuality, intimacy and cancer (Cancer Council) – key information for people with a cancer experience (online or as a PDF download)
  • Talking to your healthcare provider about sexual difficulties (FUTuRe Fertility) – information about sexual concerns for people experiencing cancer and tips for talking to health professionals about them
  • Headspace – an organisation for young people that supports mental health and wellbeing, including information and support on sex, safe sex, sexual health, intimacy and relationships
  • ReachOut – an organisation for young people that provides information about relationships and sex as well as tips for managing difficult relationships with others
  • Relationships Australia – useful information about managing relationships and relationship support services for people, families and communities
  • Your local youth cancer service – each Australian state has a team of health care professionals specialising in the cancer treatment and care of young people aged 15-25 that you can contact for help and advice
Advice From Clinicians



Intimacy is about so much more than sex- it’s about how we relate physically and emotionally to ourselves and those close to us. Whether you are sexually active or not, in a relationship or not, we hope that the experiences and advice shared by other young people below about body image, romantic relationships and intimacy after treatment for cancer help demonstrate that there is no right or wrong way to feel, or to be.

How has your relationship with yourself changed?

“It is in the process of becoming a lot more positive and almost worry free, beforehand I used to stress about the smallest things, now I am looking at the bigger picture and not sweating the small stuff as much and definitely enjoying socialising and getting out more. Beforehand I also was very selfish and that is changing, I have been made aware of flaws within me and I see this as an opportunity to work on those flaws.”

“It takes time to accept the ‘new’ you physically… but after treatment I am slowly regaining my prior fitness levels and seeing the old me come back SLOWLY.”

“I am so aware of my physical body now. I know when my calcium is low or if I’ve missed a dose of something because I can *feel* it. I’ve wanted improvement to my eating habits and my exercise habits, or lack thereof, for so long but I feel like this awareness of my body has driven me more than anything else has before.”

“As someone who has always struggled with body issues, it felt unbearable to have physically changed so much in such a short period of time. I spent too much time berating myself about how I looked during treatment, and even more so after. There are days where I still stand in the mirror and berate my body for everything that it isn’t rather than celebrating what it is. I still struggle with the shallowness of my own self-worth but I know it has evolved. I can now realise that if it wasn’t for this experience, I would still have an unhealthy relationship with my body.”

“Most of the time I appreciate my body for fighting this disease, and now carrying me through each day. However, sometimes I can feel angry that I no longer look the way I did; am no longer as physically strong as I once was and that sexual experiences aren’t the same. It is hard not to compare yourself to friends. I try to practice self love but sometimes this can be really hard.”

“Treatment finished 2 months ago and I don’t think I have yet fully come to understand how it changed my relationship with myself and my body yet. There was a long time after surgery and during treatment where I couldn’t have cared less how I looked as I just wanted to feel better. There was a long time too, where all I wanted was to look after my body (exercise, use skincare, heal my scars, stop being injected with poison). But I just had to wait. Now that treatment is over I have all the time to take care of my body, I just had to get through the part where I had no control and realise a time would come where I get it all back. I’ve come to realise how strong I actually am, mentally but also physically to get through what I did, and I really appreciate my body for enduring what it did so well.”

How have your intimate relationships or experiences been affected?

“I don’t feel that my relationship has changed, really. I still feel the same connection as I always have with my partner.”

“I feel emotionally closer with my partner; sexually we are further apart. Recovering from surgery, being thrust into early menopause and having a temporary ileostomy are all large contributing factors. We are starting to overcome this together, open communication with your partner is key. Individually, I am linking in with additional services in the area of sexual health- it took some time for my team to suggest this referral.”

“A timely question, my long term girlfriend broke up with me after treatment. As far as I am aware it was not because of the cancer. There were other factors. However I was not feeling confident within my own body after my final surgery and was self-conscious and had close to no confidence. That has meant I have not had sex since. I am also not wanting to as I don’t particularly like anyone and honestly there is a part of me that is worried of being judged. The challenges are gaining confidence within myself in terms of my body and in terms of who I am as a person and my ethics and values. I guess I have blurred my mistakes into my cancer experience and see it as a chance to start again.”

“My relationship with my partner changed a lot. By default he became basically my primary caretaker during this time. A role he assumed without any question or even much discussion, I think he felt he didn’t have a choice, and not in a way in which he was forced but more that he couldn’t imagine it any other way, which on its own, I am incredibly grateful for. Since treatment it feels like both of us have become so much more thankful for each other, at least I know that’s true for me. Now that we can properly enjoy life again and do what we want, it feels all the more special. He is my hero now and I will never forget what he did for me and what he sacrificed to get me through this time, so that is a huge change in our relationship from my end.”

“I definitely seek more validation and comfort from people than I used to. I don’t know if it’s because I’m scared or scared to be alone but there is a loneliness that has stayed for me. Perhaps the restlessness has always been there, perhaps the two years in remission has felt ordinary and I uninspiring for not doing something more than being 24. But as my friends remind me: that is my job. To be 24, to make mistakes, sleep with the wrong people, fall in love with the worst ones, be selfish, have fun and to make the most of the now because the present is never to be repeated- we must live in it. I’m trying to be more patient and understanding with myself since this all happened. It’s not easy but even on the worst days, there is always some goodness and that’s what I’ve learned to hold onto.”

“My intimate relationship changed massively during treatment and then again afterwards. I read lots of stuff telling me how my intimate and sexual life would might change but I kind of dismissed this information before I realised how relevant it was. Feeling as sick as I did, I didn’t want to have much of a sex life at all. I didn’t really like how I looked and definitely didn’t feel good, so the thought of either me or my partner touching me was so far from what I wanted. During my break weeks from chemo my boyfriend and I had sex maybe once, but I think it was less because we wanted to and more because we thought we needed to try.

Emotionally though, my relationship with my boyfriend was the most nurturing it’s ever been, and that more than made up for a lack of connection physically during this period. I think it was good for us to put things like cuddling and just holding hands on as high a pedestal as we normally would sex. These things were instrumental in our intimacy during chemo. It was also challenging to accept that if there ever did become a moment where I felt well enough to have sex it didn’t mean my partner was ready, nor that my body would be. Also that if both of those things aligned, accepting that sex had to be different was huge too. It had to be a lot more calculated and controlled. We had to get lube (as the drugs affected my natural lubricant) which we had to talk about during sex, and my energy levels were so affected as well, every aspect of the experience had to be talked through, which took a few goes for me to come to terms with. Since we have started returning to a normal sex life I still hold things like cuddling and holding hands in a higher regard than I did before, which is super nice. Also just talking about being excited for a time when we could return to having sex was important. It reminded both of us that we did still want each other, and helped me picture the returning to of normal life.”

What surprised you? 

“[That] I feel ok with my scar (26cm vertically across my abdomen). When I am being critical about myself it is never about my scar.”

”I was surprised at how quickly and dramatically my body changed when not doing any physical activity. And how mentally affected I was by my physical changes.”

“How accepting my partner has been throughout the whole thing, but then again it doesn’t surprise me.”

“How you can listen to your body and how quickly it can improve with hard work and determination, the hard bit for me has been listening to my body and knowing when it wants a break. I’ve also been surprised that there are people out there that will judge you on the way you look. Then there are people who look up to you and seek strength from you.”

“My recklessness. I’ve always been one to throw caution to the wind when it comes to sex though before, I was scared whenever I did so- now I’m not.”

“I got my period after radio treatment which is NOT FUN. I have implanon and getting my period was completely unexpected and no one even told me that it might affect me in that way- even though we did have a discussion about when my last period was and what birth control I was using. I was not prepared at all for it. It makes total sense because my hormones are being affected by the way my body has changed but I just wish I’d had more warning.”

“I was surprised by how much my sex drive was actually affected. And also how I didn’t feel much sadness about missing my sexual relationship during this time, as I knew it would return (thanks mostly to my partner being so encouraging).”

What advice do you have for others?

“It isn’t always easy, but be kind to yourself.”

“Be proud of your scars both on the outside and in (I’m still trying to be proud of the inwards ones) [because] they represent the fact you’ve gone through an ordeal and made it through the other end. Also no doubt your body will go through changes if you have surgery. Use it as an opportunity to start fresh and become stronger than you were before. It’s not permanent, and if people judge you or stare at you they really aren’t worth your time, they should be admiring your strength and resilience instead of the fact you don’t have hair or [are] not as muscly as others.”

“My advice would be celebrate the little things! While everything starts to become normal all at the same time, don’t forget how hard some stuff was during treatment. Patting yourself on the back when you can do small things like get through a meal without thinking about how hard it is, returning to normal bowel functions, going up that set of stairs without getting puffed, things like this are all absolutely worth quietly celebrating with yourself. Also patience patience patience. There’s no telling how long it will take your body to start looking and behaving normally. Same goes for sex life and relationships. Don’t worry yourself if things seem not to be going back to how they were, chances are they will, it will just take some time.”

“As hard as it is (and I probably didn’t have the guts to ask my oncologist), ask to talk to a nurse about sexual health and advice on the matter. I felt more comfortable talking to [my nurse] than one of the doctors on the matter.”

“You can never go back to the person you once were. All that’s left to do it figure how who the person you are now. Take your time, even if taking it seems unbearable. When you reach the point where you’re ready to dip your toes [back] in the sexual pool- dive. Experiment and play and ask for what you want. Sex is the only thing that’s free from distraction- it requires presence and touch and pleasure- why deny yourself any of it?”